Arrhythmias & electrophysiologyRandomised controlled trial
Early substrate-based catheter ablation vs. antiarrhythmic drug therapy for ventricular tachyarrhythmias among patients with prior myocardial infarction: the MANTRA-VT randomized trial
- Randomised controlled trial
Authors' conclusion
Early substrate-based RFCA was associated with reduced risk of ICD therapies, but with no meaningful difference in VT/VF burden, mortality, hospitalization, and adverse events.
Study context
- Population
- AAD-naïve post-MI patients with implantable cardioverter defibrillator (ICD) and ≥1 documented VT/VF episode after device implantation
- Participants
- 58 patients
- Comparison
- Early substrate-based radiofrequency catheter ablation (RFCA) vs AAD therapy
- Primary endpoint
- Cumulative number of ventricular tachyarrhythmias (VT/VF burden)
- Follow-up
- 12 months
Primary result
As reported in the abstract
VT/VF episodes
RFCA
0
median · range 0–3
AAD
0
median · range 0–23
P = 0.454
Secondary outcomes
Appropriate ICD shocks · 12 months
P = 0.026
No ICD therapies · extended follow-up
P = 0.012
Total mortality · 24 months
- No significant difference between the groups in total mortality: HR 1.02, 95% CI 0.20-5.11
- P = 0.86
Hospitalization · 24 months
- No significant difference between the groups in hospitalization: HR 1.35, 95% CI 0.36-5.09
- P = 0.66
Safety
Therapy-related adverse events
P = 0.10
Original publication
Early substrate-based catheter ablation vs. antiarrhythmic drug therapy for ventricular tachyarrhythmias among patients with prior myocardial infarction: the MANTRA-VT randomized trial. Europace. Published 15 October 2025. doi:10.1093/europace/euaf236
Summarised from the published abstract; every number is checked against it